Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

Customer Service Representative

📁
Manager & Professional
📅
190QZ Requisition #
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Date:                                      October 9, 2019


Position:                                Customer Service Representative (Service), Albany (47)


Labor Grade:                        7


Hours:                                   35 hours per week (full-time)


                                              Monday-Friday, 10:00a.m.- 6:00p.m.


      (Must be available for full time training for full duration of training from 9:00a.m.-5:00p.m.)


Location:                               Albany (80 Wolf Road)                         


Description of Duties:


  • Receive, answer and/or record telephone/correspondence/e-mail inquiries from subscribers, providers, and other consumers relating to areas of coverage, payment of claims, membership status, medical management intake calls, etc., under the various EmblemHealth medical/surgical, dental, hospital and Medicare plans.
  • Review inquiries, correspondence and email receipts.  Prepare email resolutions, letters (form or narrative letter) and/or claims payment process adjustments.
  • Perform written and verbal duties of the position to meet company goals for production and accuracy.
  • Perform related claims approving and clerical work as assigned.
  • Perform other duties as assigned or required

 

Qualifications:

  • Must be able to work under pressure, handle stressful situations effectively and deal politely with subscribers and providers on the telephone, in person, and email/correspondence
  • Ability to detect and relate problem service issues to management
  • Ability to speak well on the telephone and maintain a positive telephone personality.
  • Must be able to compose clear concise letters
  • If designated, sort and screen correspondence receipts and resolve via coding of additional payment, possibly including salvage and/or completion by letter
  • Typing and PC skills
  • Ability to adapt to change and address multiple issues simultaneously
  • Good organizational skills
  • Must be available for training
  • Regular attendance is an essential function of the job

Education and Experience:


  • A minimum of two (2) years’ experience in customer service; one year must be in a call center setting.  A college degree is preferred.  Health insurance experience is a plus.
  • Must be available for training
  • Test Subjects:
    • Online: Reading Comprehension
    • Online:  Customer Service
    • Oral Telephone Simulation; Interview
    • A language assessment test will be conducted for an applicant who passes the online tests and telephone simulation


EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

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